I've finally gotten around to scheduling my second NA procedure, this time with Dr. Pess in NJ. I posted in the fall about my intent to do this, but am just now getting around to it (paraphasing John Lennon, life is what happens when you are in between Dupuytren's procedures).

Anyway, Dr. Pess's office asked me a question I didn't expect -- what kind of anesthesia do I want? I had an NA done two years ago by Dr. Denkler in the SF Bay Area, and he used a local - -he didn't even mention other options. But apparently Dr. Pess leaves the choice up to the patient.

I was fine with a local with Dr. Denkler (the needles to inject the local hurt quite a bit, but it was pretty easy after that). But the area I'm having done this time is much more extensive -- there is a complex of cords in my palm that fan out and are contracting 3 and possibly 4 fingers at the MCP joint, and at least one of the cords is very thick. I had another surgeon tell me about a year ago that if he did this hand he would recommend twilight sleep, because the area was so extensive. He said the area would require so many local injections that it would be really hard on a patient.

Dr. Pess said it's really a personal choice; he said he has done larger areas with just a local, and some patients want twilight sleep for even small areas. The downside to twilight sleep is you need to fast before the procedure, you need someone to drive you home afterwards, and it costs more. (For those of you outside the U.S. who might use different jargon - what we call "twilight sleep" is moderate anesthesia administered through an IV - you aren't entirely asleep, but you are pretty out of it mentally and don't remember much afterwards - kind of like being very drunk.)

I'd love to get input from anyone who's had experience with either option. I'd also love to hear from people who have experience with NA on thick cords. My big one is about 1/4 inch wide (0.6 cm for you metric folks).

Thanks in advance for your feedback!

Maddie

What is a "FDS slip excision ?

I have had two failed trigger finger releases on my right index finger. They finally found the cause was Dupuytrens that they could not see earlier. The cords I have are in the webbing between my thumb and index finger as well as several other places in both hands.

The FDS slip excision is removing one branch from one of the two tendons in my finger. It is invasive, but should finally stop the trigger finger.

Hi Maddie,

I'm with LubaM... go for a local to minimise the danger of nerve damage - 'Twilight Sleep' and you'd possibly be too far out of it to know - or care!!

potter

I don't know. I've had twilight sleep for a different procedure and could still feel pain. I think you'd feel it if someone got too close to a nerve with a needle. It's more like being super relaxed than being asleep. Dr. Pess has done many NA procedures. I can't imagine he would recommend something that would increase risk of nerve damage.